EMAIL US
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First Name *
Last Name *
Email *
How Did You Find Us?
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Former client
Other personal recommendation
Google
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Visajourney
UALadies
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Your State of Residence *
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Alabama
Alaska
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Fiance(e) Country *
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Afghanistan
Albania
Algeria
American Samoa
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Australia
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Dominican Republic
Republic
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El Salvador
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Ethiopia
Faeroe Island
Fiji
Finland
France
French Guiana
French Polynesia
Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Great Britain
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Greenland
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Guadeloupe
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Guinea Bissau
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Ireland
Northern Ireland
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Case Facts and Questions *
Met Fiance(e) in Person? *
Yes
No
Total Time Spent Together in Person *
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over two months
one month to two months
two weeks to 4 weeks
one week to two weeks
under one week
Your Occupation *
Phone Number *
Last Meeting Date
Your Number of Marriages
Your Age
Fiance(e)'s First Name
Fiance(e)'s Age
Your Income (AGI from last tax return)
Your # of Dependents
Ever Sponsored Anyone for a US Visa
Yes
No
Fiance(e) Ever Overstayed a U.S. Visa?
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Yes
No
Not Sure
Fiance(e) Ever Had Another U.S. Fiance(e)?
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Yes
No
Not Sure
Fiance(s) Ever Sought Visa to US?
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Yes
No
Not Sure
Fiance(e)'s English Level
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Excellent
Very Good
Good
Fair
Poor
Fiance(e)'s Marital Status
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Single
Divorced
Widowed
Married
Fiance(e)'s # of Prior Marriages
Fiance(e)'s # of Children